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industrations · 7 months

Note

my little guy.

i know that your prompts and requests are closed.

as i am the light of your life, however,

i just need a sprinkle

of your affection

in the shape of

an egg

Eggie

#space jellyfish #but like fen said #my requests are closed so please don’t send any more #i’m working on the ones i still have #reggie of the day

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eikotheblue · 6 months

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Behold! This absolutely incredible drawing of me as a Pokemon gym leader, drawn by my wonderful and incredibly talented friend Fen @salt-and-bramble 💙💙💙

I love it so much as a work of art and as a drawing of me and I'm using it as my profile picture everywhere now.

Fen did a wonderful job of - capturing lots of details that match up with things I actually wear (the heart gems I put on my forehead, my favorite top with the boob window, the galaxy print on my favorite dresses, the color of the glowy wheels on my skates), while also adding so many delightful little things that spark so much delight in my soul (the heart-shaped pupils, a much fancier design on my gloves than I currently have, the poi-pokeballs, a lil bit of embellishment on the cleavage) and. the hair.

Gods, the hair. Y'all have to understand - I've legit never seen a picture or depiction of my hair I've loved anywhere close to how much I love this. I've gotten a lot of compliments on my hair over my life, and despite historically really hating it, lately I've been figuring out ways to get it in a state where I can appreciate it myself, which has been a slow and strange process. But when I first saw this drawing, I felt like I understood for the first time what people are seeing, when they look at my hair and tell me it's beautiful. (When I told Fen this, they said I have the curls of the ocean... ;-; this has stuck in my head, and I think of it when I look at my avatar or my hair.) And the action lines in the rest of the piece really enhance the wave vibes...

it's just so perfect ;-;

#there's more to the story of how this image came to be and why the comment about smarthome bullshit and the other people involved #but - I'll be posting that later #because I've been writing this post in my head for the last several weeks and today it finally came out like this #and the perfect should not be the enemy of the good #and I know I've already said this but #thank you so much Fen #I love this I love you I'm so so so glad you're a part of my life #these last 2 months have been horrible but your support has made them so much more manageable #and this picture was one of the purist and brightest spots in that darkness #and it means the world to me #💙 💙 💙#personal #art #gym leader sona saga

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into-the-feniverse · 7 months

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Fen Quirk Analysis: Brought to you by Izuku Midoriya 🧊

Most of this info is already documented in her ref sheets, and she has a pretty general run-of-the-mill “ice” quirk, but thought it’d be fun to illustrate and get into the science of it all

More elaboration (& rambling) under the cut:

——————

Fen’s quirk works by allowing her to extract the heat of whatever it is she’s touching, which often produces frost as a byproduct of the rapidly cooling surface temperature in relation to the air. Her fingers/hands act as conduits, allowing for the heat energy to transfer through her. As a side effect, while actively using her quirk those points of contact heat up/become hot to the touch, but only for however long she’s using her quirk for.

The heat she extracts travels through her body and gradually loses energy (due to her own internal temperature running fairly low) then gets released back into the air. However some of her own body heat also gets lost in the process, virtually making her into something like a heat vacuum.

The rate at which she cools also affects the effects of her quirk, in that the more rapidly she cools something, the hotter her contact points become and the more body heat she loses, putting her at high risk for frostbite and hypothermia. The temperature discrepancy also just causes general (to severe) discomfort.

Her quirk isn’t as effective in drier environments, as lower moisture content means less frost generation.

So ironically her quirk isn’t so much “frost” as it is heat transfer 🤔 and really frost is just a (very common) byproduct of her quirk lol

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laindir · 1 year

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lol I’m just thinking about the best thing I’ve ever done/worst mistake I’ve ever made with regard to reading jjk is the realisation (while in the midst reading of the Shibuya arc) that Fushiguro Megumi is my favouritest character, because:

1. Alongside Yuuji, he has always been central to the overarching themes and main narrative of the plot = hence more screen-time, character conflict/struggles, and gradual character development for Megumi overall

2. BUT AT WHAT COST ?????

#jjk manga spoilers #fushiguro megumi #the cost is my heart and crumbling sanity i guess :’))#tbh if i hadn’t been riding off the good carthartic feels of BD #i think i’d be feeling absolutely terrible lol #maybe j-fen was right when they said megumi is like a CLAMP character too lol #tldr keysmashing with feels #useless text post #jujutsu kaisen

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spid3r-trans · 10 months

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ok so i decided to make more of a personal blog??? i feel like this one is pretty dedicated to spiderverse/writing and i feel weird about like rbing certain stuff here so this is my solution

absolutely no obligation, i think i’ll still operate primarily here but if ur interested in my other delusions and silly little scenarios they’ll be over @fenh4rel

#fens fables #😌#i’ll also do a tagging system over there for different fandom stuff #there’s nothing over there rn but like i said i felt weird abt it #i think this will end up being like writing and hyperfixation central #and there i’ll be normal

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ziracona · 1 year

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Even Fenris stans can acknowledge that that's mainly a trauma response on his part, like it's not his fault. And yet Sebastian Stan's just fly off the handle at a simple joke? Damn they need to chill...

Yeah. There’s nothing to gain from arguing bc it’ll just go in circles, but I am very tired of people coming into my own spaces to bother me or friends. I think that difference is cause they came from different places. Like sure Fenris and Sebastian have some overlapping opinions, but not all, and Fenris has character beyond his politics is the thing. Like. Usually Fenris stans either liked him because he’s hot (neutral motive), he’s edgy (neutral), he’s a minority (positive), he has an interesting arc (positive), or he’s got trauma backstory (positive). Usually Sebastian stans like him because he’s a Catholic Trad Husband (negative), he stans the religious oligarchy and their oppression (extravagantly negative motive), he’s a basic straight white boy who thinks minorities are dangerous and his religion and culture are better than them & they should convert (very very negative), and has a tragic backstory for which he undergoes basically no character growth after but uses to act entitled to judge everyone else’s reaction to their own (also very negative). So the stans are very different types of people.

#there’s a lot that could be said but the short version is Fenris has charcater which means things are interesting abt him as a person #whereas the only draw to Sebastian is if you like what he is the poster boy for (religious oligarchy facist oppression) bc he has the most #nothing character of all time. so people who like a charcater like Fen will vary. people who are there for stanning the Chantry won’t really #ask #anonymous #da2

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littlefoxwarrior · 1 year

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Since you guys liked the bust I posted, here the full piece with some touch ups I did lol. (ignore the shoes also he/him for the character)

#like fen said Lupus moment!!#pls be nice im new to this tablet and stuff #but i feel like i popped off with the shading

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velvetlilacsdaisies · 5 months

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Shit at Feelings i

Part one

Pairing: Bodhi Durran x fem!marked one!reader

Synopsis: Bonding with dragons? No issue. Killing venin? Unfortunate, but doable. Confronting your feelings towards your childhood best friend? No thanks.

Word count: 1.6k

Warnings: SPOILERS!!, drinking, swearing, filler dialogue, not proofread v well. lmk if I missed anything

A/n: my first Emperyeon series fic!! Was supposed to be just a one part fic, but I got carried away. I also just wanted to write a self indulgent piece w dialogue amongst the group too 🥲 this is my first time in a while posting but I fr love Bodhi sm I needed to have something w him in it. I hope you enjoy!

༺☆༻ ༺☆༻ ༺☆༻ ༺☆༻ ༺☆༻ ༺☆༻

You survived your first year, you defied the odds of what everyone else said about you. Not only defying those odds, but being one of the best in your year. Maybe Imogen and Xaden had played a crucial part, but most of the marked ones were surprised. You had been more quiet and reserved out of the group of kids for the high ranked officials, but that didn’t mean you were weak. You had proved that while being ruthless and cunning in your training. Your parents were Fen Riorson’s top battle strategist and healer after all.

In the gathering hall, everyone celebrated moving into their new ranks. While simultaneously saying goodbye to the third years they’ve grown to know. You were indulging in the alcoholic lemonade, and your fellow fourth wing with more than a few words tonight. You sat on the left side of Violet while Imogen sat on the right. Nadine and Sawyer next to Rhiannon across from you bickering playfully about something. You savoring your newfound will to live after the events at Resson.

The hall was sweltering in the summer evening heat, no amount of lesser magic had helped. Neither did the warmth you could feel from Ridoc beside you. Taking your jacket off, only being left in your tank top underneath.

“Damn Y/n,” whistled Ridoc. “I don’t think I’ve ever seen your relics yet.” Everyone’s eyes went to you, and usually you would’ve been intimidated by all eyes on you. Tonight it didn’t faze you that much. Even noting the softened gaze in Nadine’s eyes, who had been skeptical of the kids of the rebellion at the beginning of the year.

Both sides of your collarbones are covered in intricate designs extending to shoulders making their way down to your biceps on both arms. You never tried to hide the relics, but you never took your jacket off or opted for a long sleeve, higher collared shirt when training in lessons.

You rolled your eyes at the male’s cheekiness and everyone gawking besides the few who knew what already laid beneath your jacket. “It’s not something I necessarily flaunt.”

“Obviously or we wouldn’t all be shocked here.” Sawyer snorted, sipping on his beverage.

“It’s so badass though.” Violet acted as if she hadn’t only seen it days prior.

“I had been fortunate in the placements of them. Since both of my parents were a part of Riorson’s regime.” You tried not to be bashful about it.

“Where’s your dragon relic?” Ridoc blurted as he looked at the design on your shoulders.

“Sheesh,” Rihannon reached over, flicking his ear. “You’re staring like you’ve never seen any relics before.”

Before you could give a response, something caught the youngest Sorrengail’s eye causing her to get up. “I’ll be back.” Violet stood up from the table, wobbling tipsily to the corner where you saw Xaden and Bodhi. The latter descended, seeing the silver haired girl approach them, offering a curt nod when they passed one another.

You gulped at how good Bodhi looked in his new third year jacket, even when it bore no difference to his second year uniform. You were just a sucker for Bodhi in a uniform admittedly. The mage lights illuminating his dark curls to a chocolate hue that tempted you to run your fingers through his hair.

Despite being close with Xaden, Imogen, and even Garrick—you kept your distance from the younger man for a year before he left for Basigath. When you were kids, you two had been close friends, maybe even inseparable. But when a rebellion happens, and you have increasingly become aware of how much your affection for him went so much deeper than being his friend—things become complicated.

When you were around him now it was the only time you felt truly timid. You could conquer the parapet, gauntlet, bond a dragon, kill venin and wyvern, but that man was your weakness. He had narrowly saved you and your dragon from a wyvern attack while back in Resson.

His cheek still dusted with a greenish yellow bruise, and jaw gashed with a healing cut. Unashamedly you thought it made him look so much more lethally handsome than he was. Gods you were resorting to a bumbling nervous lovesick puppy.

“Human women and their finicky hormones and emotions.” Your dragon, Cleasaí, chortled through your bond.

“Quiet, go eat sheep or something.” You slammed your mental shields up from her to the best of your ability while intoxicated.

Bodhi reached the table, already looking at you. His hazel eyes shimmered with curiosity as he scanned your exposed arms and collarbones. Either not used to lack of sleeves or was it the fact you unabashedly stared back for once. His mouth curled into a lazy smirk. You hoped he didn’t notice your already flushed warm cheeks redden under the mage lights, feeling a ghost of smirk on your own lips. The lavender lemonade made you feel bolder evidently as well.

“Mind if I squeeze in?” He asked, keeping his eyes locked on yours stil.

“I can move over—“ Imogen started moving closer to you, but he had already stepped over the bench to take a seat in between the two of you. “Or not.” She deadpanned. She had been one of the only ones that knew the complicated timeline between the two of you.

Your heart skipped a split second from the stare down between the both of you. Now feeling acutely aware of your posture and the swarm of what you could only compare to bees buzzing around in your stomach.

“Y/n,” he greeted casually, his voice a warm husky tone.

“Bodhi.” You tried to play cool, and take a sip of your frothy drink. Not only did you know he was looking at you, you could see Imogen in your peripheral, giving you a “what-the-fuck” look at the interaction. Ignoring the pink haired girl, you spoke up again. “Feel like a third year yet?”

“Eh, it won’t hit me until the new candidates get here.” He finally took his eyes off you as Ridoc offered him a bottle of ale. “Thanks man.” Bodhi’s side pressed up to you when leaned over to take the bottle.

His warmth doubled down into you, igniting the exposed skin where he pressed into you. Feeling his minty breath fan the side of your face, and the smell of cedar, patchouli, and musk invade your senses. You could feel his hard muscle flex through the layers of his clothing against your bicep. The storm that buzzed through your stomach turned into heat seeping into your core. Lovesick puppy or just desperate for male touch?

“I know I will be taking every advantage as a second year,” Nadine chimed in. “Finally being able to sleep in is priority number one!” She did a little celebratory dance in her seat. You snapped out the trance Bodhi left you in, and agreed with her.

“I’ll be savoring our newfound alone time too.” An extra hour in the morning, and weekends to actually do something more than chores or training. Maybe you can finally break out the sketch book that someone smuggled in for you during a supplies trip. You only found it on your bed with no note.

“Define alone time, Y/n.” Rihannon wagged her eyebrows at you. The group chuckled at the suggestive comment.

“Or will you use your newfound freedom to bring someone into your room finally?” Ridoc added, causing the group to laugh louder. If you weren’t red enough already, you had to be beet red now.

“What makes you think I haven’t already?” An inquisitive eyebrow raised at the shorter male from beside you. ‘Oohs’ rise from the group.

“Did you want to be number one, Ridoc?” Quinn giggled.

You felt both the male in question and Bodhi tense. The former blushing a deep scarlet in embarrassment and the latter wearing a neutral expression you couldn’t decipher.

“Sounds like you’re keeping watch of me.” You teased playfully. The flushed male who usually was never at loss for words was now stammering trying to deny it. “It’s okay, maybe one day I’ll take your consideration if I’m ever bored enough.”

“Not what I meant.” Ridoc put his hands over his face groaning. You finally let out a laugh from his reaction, you couldn’t help getting the slight joy of teasing him. He always got the joy of doing it to everyone else. It seemed the rest of the group was enjoying teasing the man just as much too. Everyone besides Bodhi, who had a slight scowl on his face until Imogen whispered something to him.

༺☆༻ ༺☆༻ ༺☆༻ ༺☆༻ ༺☆༻ ༺☆༻

By the end of the night, everyone was just about ready for bed drunkenly chatting and giggling at one another. You had consumed two more tall glasses of lavender lemonade. Most of the group now were clamoring around getting clumsy and incoherent. While you were trying to stay sane while remaining seated next to the guy you’ve always had undeniable feelings for. Overly aware of every little action he did at the table throughout the night. From him laughing to the way he gripped the bottle of his alcohol. Lovesick puppy.

You had stood at the exit of the hall up to the dormitories with Ridoc and Rhiannon. Both have to hold each other up as they bid you goodnight.

“Y/n,” Ridoc hiccupped. “I wasn’t serious about earlier, but if you’re—“ hiccup “serious I can be—“ another hiccup “serious.” You did everything you could not laugh out loud knowing it was the alcohol talking.

“She wasn’t.” Bodhi came up next to you, giving him a glare. You shot him a look, not used to such a serious or broody version of the man you grew up with. Him always being the friendlier one out of Xaden, Garrick, and himself. “Goodnight you two.”

Rhiannon’s eyes widened in a shocking delight. “I knew there was something between the two of you!” She squealed, like he bared his soul with a couple words.

“There is—“ you go to correct her, but the tall male beside you cuts you off.

“Goodnight Cadet Matthias.” He had an authoritative tone that made your knees buckle. Or was that the alcohol? His muscular arm wrapped around your waist as he noticed your unsteadiness, and you felt that same sensation you felt earlier when you leaned into him for support.

Your two fellow second years gave the both of you looks before clumsily walking away, leaving you alone with the male holding you up. Your heart is now hammering as he starts to lead you away.

“Let’s get some air.” Bodhi motioned his head to the courtyard as he effortlessly led your stumbling form outside. You wanted to scoff at his proposition. Your new bed and pajamas were calling your name.

A few cadets and lieutenants lingered around the expansive yards, but he quietly led you to an alcove that brought you to a secluded spot where no one could see the two of you.

You leaned up against the stone wall, letting the summer breeze cool your skin. Carefully observing the tawny skinned man from beside you. He took out a small rolled paper and a match, lighting the roll and the sweet smell of churam filled your nose. You weren’t allowed to smoke, and you knew if you were caught you two would be expelled and possibly executed at this point.

“What are you doing?” You hissed as he took a drag, watching him let the smoke leave his mouth and inhale through his nose. There goes that damn buzzing feeling in the pit of your stomach again.

“Relax this is our smoking spot, Y/n/n, no one comes around here.” He reassured you once he exhaled the smoke again. You rolled your eyes staring at the mage light that flickered on the wall. After a lengthy pause, you glanced back at him.

“What makes you think I wasn’t serious?” You questioned, crossing your arms around yourself.

“You know these are the most words you’ve spoken to me in months? Maybe even years?” He ignored your question.

You opened your mouth, before closing it again. You couldn’t admit it was because of your harbored feelings. Not now. Because he was right, you hadn’t talked for quite some time. It didn’t feel right nor did you want to omit that confession.

“Well you were here for an entire year and I was back home so yeah it’s been a year since we talked.” So you played oblivious with him.

He scoffed, “you’ve hardly spoken to me since you’ve gotten here.”

“You just seemed so busy—“

“Cut the shit, please.” He pleaded, now anxiously dragging the joint.

As he brought it away from his lips after a couple puffs, you stole it from him. Your fingers brushing slightly as you grab the small rolled herb. The small touch warrants an electrifying feeling between your fingers. Quickly brushing the thought of if he felt it too, you took a hit of the herb. Letting the sweet smoke seep into your lungs and haze the self awareness and guilt that filled you.

You didn’t want to let him in, truthfully. You’ve already witnessed too many losses during the succession and your first year alone at Basigath. It was when your parents had been executed when you started slipping away from him. You let the stereotypical crush trope hide deep down what you felt, how afraid you were. It would hurt to know, if you finally got the balls to admit everything you’ve felt, and something happened to him or you. It already almost did once, the regret and shame still kept a hold of you for the last few days.

You could now see the disappointment in his eyes. “You’ve always been quiet and reserved, but with me? That’s never been you.” You took another deep inhale of the herb.

“Could you blame me if I was scared?” Your hands slightly shook as you handed the joint back to him. Your eyes were earnest as you looked at him.

He shook his head, running hand through his hair. “You're scared? Fuck, Y/n I almost watched you die. And you know what ran through my head thinking ‘this could be it’?” He took one last smoke, throwing the remaining part of the joint on the ground, stomping it out into the cobblestone. “That the last fucking year spent with you was speaking through a chain of command or small talk bullshit when you weren’t running the opposite if I was near you for too long.”

A lump formed in your throat, and you could feel the tears burn the edges of your eyes. That electric current you felt in your stomach only a few moments ago had solidified into a brick. Then ascended into a wall that crushed you with an iron force with his words.

You two had only briefly talked while in Aretia after what happened.

You had tended to your dragon most of the time while waiting for Violet to heal. Your green clubtail had a poorly injured claw from a wyvern, and despite her persistence it would heal, you were nervous that it would draw too many questions back at Basigath. Xaden agreed and saw Brennan to help mend some of the wound once Violet was stable. You were not able to leave her side while the stranger tended to her. She was already furious that someone besides you had to touch her.

You wanted to talk to him more after that, everything had happened so fast though. Then you went back to avoiding him.

“You’re right.” You mumbled, picking at the edge of your nails. “I’m so sorry, Bo.” Your lip trembled, and the first tear slipped from your eye.

He sighed, sounding defeated. “Gods, I don’t want to be right.” He gently grabbed your elbow, wrapping your smaller frame in his arms. “I want you to stop icing me out, Y/n.”

He ran a hand through your hair, his chin resting on top of your head as you sniffled tears silently running down your cheeks. He had every right to be upset with you, but here he was comforting you. This had always been the Bodhi you knew, how he was before the height of the rebellion. Whereas you had turned cold, letting your cowardice and stubbornness control your emotions—for what you thought was for good reason.

“I know,” you stifled against his jacket. Finally wrapping your arms around him. His grip tightened, and you were overwhelmed by the sense of comfort. You hated what this man did for you and to you.

“I shouldn’t have had this conversation tonight.” He admitted. “I should have waited until we were both sober.” He let you go, and you wished you were still wrapped in his muscular arms. A cold seeping into you that wasn’t due to weather.

You shook your head, a sad smile on your lips. “I would have run.”

“And I wouldn’t have had the courage to bring it up.” A dry chuckle echoed through the quiet alcove.

“We’re riders and we’re—“

“Shit at feelings?” He mused as he watched you tug your jacket on. You wiped some stray tears from your cheeks with your sleeve.

“I was gonna say pansies, but that works.” You sniffled, as a toothy grin finally appeared on his face.

“Should we get to bed and do this all over again tomorrow?” He offered his arm. You raised an eyebrow at him, was he sane? “I mean the drinking part, not the arguing. I enjoyed hearing more than a word out of you tonight though. So I can resort to arguing if needed.” He nudged you slightly.

You rolled your eyes teasingly, “no promises.”

༺☆༻ ༺☆༻ ༺☆༻ ༺☆༻ ༺☆༻ ༺☆༻

Reblogs and likes are appreciated! I am open to feedback as well as requests too! 💕🫶

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scientia-rex · 8 months

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Because my most popular post is about weight loss and how it's a crock, I get a lot of questions about various things, including bariatric surgery--just posted the link to the post I did about that--but also Ozempic/Wegovy, the once-weekly injectable semaglutide medication that was developed for diabetes but was found to have independent benefits on weight loss.

I always said that weight loss was like Viagra: when a medication came along that actually worked, it would explode. We'd all hear about it. Fen-phen in the 90s worked, but it was bad for your heart. Stimulants, like meth, may cause weight loss, but they do it at the cost of heart health, and raise your likelihood of dying young. Over the counter weight loss supplements often contain illegal and unlisted thyroid hormone, which is also dangerous for the heart if taken in the absence of a real deficiency. Orlistat, or "Alli," works the same way as the Olestra chips Lays made in the 1990s--it shuts off your ability to digest fats, and the problem with that is that fats irritate the gut, so then you end up with fatty diarrhea and probably sharts. Plus Alli only leads to 8-10lbs of weight loss in the best case scenario, and most people are not willing to endure sharts for the sake of 8lbs.

And then came the GLP-1 agonists. GLP stands for glucagon-like peptide. Your body uses insulin to make cells uptake sugar. You can't just have free-floating sugar and use it, it has to go into the cells to be used. So if your body sucks at moving sugar into the cells, you end up with a bunch of glucose hanging out in places where it shouldn't be, depositing on small vessels, damaging nerves and your retinas and kidneys and everywhere else that has a whole lot of sensitive small blood vessels, like your brain.

Glucagon makes your liver break down stored sugars and release them. You can think of it as part of insulin's supporting cast. If your body needs sugar and you aren't eating it, you aren't going to die of hypoglycemia, unless you've got some rare genetic conditions--your liver is going to go, whoops, here you go! and cough it up.

But glucagon-like peptide doesn't act quite the same way. What glucagon-like peptide does is actually stimulating your body to release insulin. It inhibits glucagon secretion. It says, we're okay, we're full, we just ate, we don't need more glucagon right now.

This has been enough for many people to both improve blood sugar and cause weight loss. Some patients find they think about food less, which can be a blessing if you have an abnormally active hunger drive, or if you have or had an eating disorder.

However, every patient I've started on semaglutide in any form (Ozempic, Wegovy, or Rybelsus) has had nausea to start with, probably because it slows the rate of stomach emptying. And that nausea sometimes improves, and sometimes it doesn't. There's some reports out now of possible gastroparesis associated with it, which is where the stomach just stops contracting in a way that lets it empty normally into the small intestine. That may not sound like a big deal, but it's a lifelong ticket to abdominal pain and nausea and vomiting, and we are not good at treating it. We're talking Reglan, a sedating anti-nausea but pro-motility agent, which makes many of my patients too sleepy to function, or a gastric pacemaker, which is a relatively new surgery. You can also try a macrolide antibiotic, like erythromycin, but I have had almost no success in getting insurance to cover those and also they have their own significant side effects.

Rapid weight loss from any cause, whether illness, medication, or surgery, comes with problems. Your skin is not able to contract quickly. It probably will, over long periods of time, but "Ozempic face" and "Ozempic butt" are not what people who want to lose weight are looking for. Your vision of your ideal body does not include loose, excess skin.

The data are also pretty clear that you can't "kick start" weight loss with Ozempic and then maintain it with behavioral mechanisms. If you want to maintain the weight loss, you need to stay on the medication. A dose that is high enough to cause weight loss is significantly higher than the minimum dose where we see improvements in blood sugar, and with a higher dose comes higher risk of side effects.

I would wait on semaglutide. I would wait because it's been out for a couple of years now but with the current explosion in popularity we're going to see more nuanced data on side effects emerging. When you go from Phase III human trials to actual use in the world, you get thousands or millions more data points, and rare side effects that weren't seen in the small human trials become apparent. It's why I always say my favorite things for a drug to be are old, safe, and cheap.

I also suspect the oral form, Rybelsus, is going to get more popular and be refined in some way. It's currently prohibitively expensive--all of these are; we're talking 1200 or so bucks a month before insurance, and insurance coverage varies widely. I have patients who pay anything from zero to thirty to three hundred bucks a month for injectable semaglutide. I don't think I currently have anyone whose insurance covers Rybelsus who could also tolerate the nausea. My panel right now is about a thousand patients.

There are also other GLP-1 agonists. Victoza, a twice-daily injection, and Trulicity, and anything else that ends in "-aglutide". But those aren't as popular, despite being cheaper, and they aren't specifically approved for weight loss.

Mounjaro is a newer one, tirzepatide, that acts on two receptors rather than one. In addition to stimulating GLP-1 receptors, it also stimulates glucose-dependent insulinotropic polypeptide (GIP) receptors. It may work better; I'm not sure whether that's going to come with a concomitantly increased risk of side effects. It's still only approved for diabetes treatment, but I suspect that will change soon and I suspect we'll see a lot of cross-over in terms of using it to treat obesity.

I don't think these medications are going away. I also don't think they're right for everyone. They can reactivate medullary thyroid carcinoma; they can fuck up digestion; they may lead to decreased quality of life. So while there may be people who do well with them, it is okay if those people are not you. You do not owe being thin to anyone. You most certainly do not owe being thin to the extent that you should risk your health for it. Being thin makes navigating a deeply fat-hating world easier, in many ways, so I never blame anyone for wanting to be thin; I just want to emphasize that it is okay if you stay fat forever.

#the attending dr. kristophine

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